Disparities in Community-Based Rehabilitation Following Stroke: Findings From the COMPASS Trial

Area of Science:

• Rehabilitation Medicine
• Health Services Research
• Stroke Recovery

Background:

• Community-based rehabilitation is crucial for stroke survivors.
• Sociodemographic and geographic disparities in post-stroke rehabilitation are understudied.
• Understanding these disparities is key to equitable care.

Purpose of the Study:

• To assess disparities in community-based rehabilitation use after stroke.
• To investigate the impact of socioeconomic status and geographic location on rehabilitation access.
• To identify inequities in physical and occupational therapy utilization.

Main Methods:

• Observational, secondary analysis of the COMPASS trial data (n=6754 stroke survivors).
• Linked patient data with insurance claims to track rehabilitation receipt.
• Used generalized estimating equations to analyze associations between socioeconomic status, rurality, and therapy outcomes.

Main Results:

• Individuals with Medicaid were 8% less likely to receive therapy within 30 days.
• Rural residents were 5% less likely to receive care within 30 days and 12% less likely to receive both physical and occupational therapy.
• Minimal evidence of racial disparities in therapy receipt was found.

Conclusions:

• Findings confirm disparities in the receipt, setting, and type of community-based rehabilitation post-stroke.
• Socioeconomic status and rurality are significant factors influencing access to post-stroke therapy.
• Adds to the limited evidence base on inequities in stroke rehabilitation.